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19 Effective Date: July 1, 2009

Approval Date: Supplemental Payments for Managed Care Clients For clients enrolled with a managed care contractor, the department will pay the FQHC/RHC a supplemental payment (called enhancement) in addition to the amount paid by the managed care contractor. These enhancements will pay monthly on a per-member-per-month basis. To ensure that the appropriate amounts are being paid to each FQHC/RHC, the department will perform an annual reconciliation and verify that the enhancement payments made in the previous year were in compliance with Section 1902(bb)(5)(A) of the Social Security Act.

An additional description of this methodology can be found on page 3 (RHC) and page 33 (FQHC) of Attachment 4.19-B of the Title XIX state plan, as approved by CMS on June 26, 2009. MPA’s Division of Behavioral Health and Recovery (DBHR) contracts with public Regional Support Networks (RSNs) to offer mental health services as prepaid inpatient health plans. To receive mental health care, all Medicaid and CHIP children are enrolled in the RSN providing coverage in their county of residence. Children enrolled in HO or in the FFS program receive their mental health care through their MCO or FFS provider if they do not meet the criteria for RSN services. In addition to psychiatrists, the following mental health professionals, when licensed by the Department of Health, may also provide mental health services beginning July 1, 2008: • Licensed Psychologists • Licensed Psychiatric Advanced Registered Nurse Practitioners • Licensed Independent Clinical Social Workers • Licensed Advanced Social Workers • Licensed Marriage and Family Therapists • Licensed Mental Health Counselors

MPA has developed procedures with DBHR to assure coordinated care. MPA sends a monthly tape to DBHR identifying Medicaid clients and their eligibility group and